Individual
ELIZABETH A BEATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1569 SW NANCY WAY, BEND, OR 97702-3234
(541) 617-0377
Mailing address
1569 SW NANCY WAY, BEND, OR 97702-3234
(541) 617-0377
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264402524
—
OR
Enumeration date
05/03/2021
Last updated
05/03/2021
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